The procedure saga continues...

[Robbyn]

Some may remember that I had to have a large cyst removed. I was concerned about the Lovenox injections - that I wasn't getting enough but apparently it is one injection and it lasts 24 hours. So I was covered there.

Now, yesterday was supposed to be last day of Lovenox. I did have an extra dose this morning. I have been taking my regular Warfarin dosage since last Thursday. My INR is still 1.3. That's five days and the warfarin is doing nothing. Why?

TIA

 

[Karlynn]

Where are you testing (home, lab) and how (venous draw or finger stick)?

Is your dose the same as before the procedure?

Have you started a new batch of Coumadin pills?

It could be that you just need to increase your usual dose in order to get in range, and then possibly have to reduce a bit once it is.

You are experiencing one of the cardinal rules of warfarin management - It's much harder to raise a low INR than it is to lower a high INR.

 

[Robbyn]

So this is fairly 'normal'.

It is drawn throught he vein, not new pills.
My INR is always too low, I take 16 mgs daily to try and keep it at 2.8. I guss I ned to be patient. The doctor told me to take 20 yesterday.

 

[Nancy]

My husband always had the same problems when going off Coumadin with bridging. Sometimes, it took him 2 weeks to get therapeutic again. He could not take Lovenox, so had to stay hospitalized with a Heparin drip for that amount of time. He hated that!

 

[Robbyn]

I have never been on Lovenox before. I have only had heparin, but I was always in the hospital.

So it could take a couple of weeks for my INR to get therapeutic. It has only been 5 days since I've taken my warfarin.

Thanks everyone for your help.

 

[Ross]

So long as you weren't given any vitamin k, it should start to rise and rise fairly quickly.

 

[donnag131]

Robbyn, hopefully by now your INR is in range. I've had a few surgeries since starting coumadin and it's always taken a couple weeks for me to get back in range. The last time my surgery was on June 18th '07 and I didn't even get to the low end of my range (2.6) until July 3rd. I also take a high dose like you do (17.5 3x week, 20mg the other 4 days) which is why it probably takes longer.

 

[Robbyn]

Donna, thank you, my INR is in range right now, well in range as much as it gets. 2.3

If one of my doctors had told me it does in fact takes a couple of weeks, I would have been more prepared. I took 25 mgs yesterday so like you said, when you have higher doses it takes longer.

This is such a live and learn drug. I remember when I came out of surgery, for the mitral valve. I was disappointed when the doctor told me I have to take Coumadin. He said don't worry there are not many side effects to taking the drug. He of course failed to mention the side effects of life, taking Coumadin.

 

[Blanche]

Robbyn:
You get used to Coumadin, you really do. It's discouraging to have problems at first, but they usually go away and things settle down.

Wishing you the very best.

Blanche